Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy

Background Data: Muscle dissection associated with posterior approach to cervical spine usually results in local pain, muscle wasting and temporarily restricted neck movement. Use of muscle sparing spinous process splitting approach for cervical laminectomy allows decompression of the spinal cord an...

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Autores principales:	Hatem Hamdy, Tarek Abotakia, Ahmad Allam
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2017
Materias:	Cervical spondylosis spondylotic myelopathy muscle sparing spinous process splitting Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/49014b61000c42c99e09b3a96beab4ee
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spelling	oai:doaj.org-article:49014b61000c42c99e09b3a96beab4ee2021-12-02T04:46:59ZMini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic MyelopathyDOI:10.21608/ESJ.2017.67532314-89502314-8969https://doaj.org/article/49014b61000c42c99e09b3a96beab4ee2017-04-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_6753.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Muscle dissection associated with posterior approach to cervical spine usually results in local pain, muscle wasting and temporarily restricted neck movement. Use of muscle sparing spinous process splitting approach for cervical laminectomy allows decompression of the spinal cord and neural foramen if needed. Meanwhile, it does not require instrumentation, fusion and it preserves cervical spine stability. Purpose: To assess the effectiveness of spinous process splitting approach for cervical laminectomy in cervical spondylotic myelopathy. Study Design: Prospective clinical case study. Patients and Methods: Patient Sample: Fifteen patients with cervical spondylotic myelopathy, eleven males and 4 females with mean age 66.4±6.6 (Range 44-71) years. All patients underwent muscle sparing spinous process splitting cervical laminectomy. Outcome Measures: Operative time and blood loss were recorded. Clinical outcome was assessed by the JOA score and VAS. MRI was done 6 months postoperative to assess decompression. Spinal stability and curvature index were assessed on plain cervical radiographs. Results: No case of wound dehiscence was recorded. There was significant improvement of JOA scores and brachialgia and neck pain VAS scores at 6 months, the mean JOA recovery rate was 56.2%. No patient had postoperative kyphosis or instability and 66.6% of patients had improved modified Ishihara cervical curvature index. No neurological deterioration was recorded in the follow-up. No patient had newly developed axial pain. MRI revealed adequate decompression of the spinal cord in all patients. Conclusion: The spinous process splitting cervical laminectomy allows good spinal cord decompression and preserves spine curvature and stability. The mini open approach and preservation of interspinous ligaments could play a role in wound dehiscence prevention. (2017ESJ133)Hatem HamdyTarek AbotakiaAhmad AllamEgyptian Spine AssociationarticleCervical spondylosisspondylotic myelopathymuscle sparingspinous process splittingNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 23, Iss 1, Pp 6-12 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cervical spondylosis spondylotic myelopathy muscle sparing spinous process splitting Neurology. Diseases of the nervous system RC346-429
spellingShingle	Cervical spondylosis spondylotic myelopathy muscle sparing spinous process splitting Neurology. Diseases of the nervous system RC346-429 Hatem Hamdy Tarek Abotakia Ahmad Allam Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy
description	Background Data: Muscle dissection associated with posterior approach to cervical spine usually results in local pain, muscle wasting and temporarily restricted neck movement. Use of muscle sparing spinous process splitting approach for cervical laminectomy allows decompression of the spinal cord and neural foramen if needed. Meanwhile, it does not require instrumentation, fusion and it preserves cervical spine stability. Purpose: To assess the effectiveness of spinous process splitting approach for cervical laminectomy in cervical spondylotic myelopathy. Study Design: Prospective clinical case study. Patients and Methods: Patient Sample: Fifteen patients with cervical spondylotic myelopathy, eleven males and 4 females with mean age 66.4±6.6 (Range 44-71) years. All patients underwent muscle sparing spinous process splitting cervical laminectomy. Outcome Measures: Operative time and blood loss were recorded. Clinical outcome was assessed by the JOA score and VAS. MRI was done 6 months postoperative to assess decompression. Spinal stability and curvature index were assessed on plain cervical radiographs. Results: No case of wound dehiscence was recorded. There was significant improvement of JOA scores and brachialgia and neck pain VAS scores at 6 months, the mean JOA recovery rate was 56.2%. No patient had postoperative kyphosis or instability and 66.6% of patients had improved modified Ishihara cervical curvature index. No neurological deterioration was recorded in the follow-up. No patient had newly developed axial pain. MRI revealed adequate decompression of the spinal cord in all patients. Conclusion: The spinous process splitting cervical laminectomy allows good spinal cord decompression and preserves spine curvature and stability. The mini open approach and preservation of interspinous ligaments could play a role in wound dehiscence prevention. (2017ESJ133)
format	article
author	Hatem Hamdy Tarek Abotakia Ahmad Allam
author_facet	Hatem Hamdy Tarek Abotakia Ahmad Allam
author_sort	Hatem Hamdy
title	Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy
title_short	Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy
title_full	Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy
title_fullStr	Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy
title_full_unstemmed	Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy
title_sort	mini open spinous process splitting laminectomy in the management of cervical spondylotic myelopathy
publisher	Egyptian Spine Association
publishDate	2017
url	https://doaj.org/article/49014b61000c42c99e09b3a96beab4ee
work_keys_str_mv	AT hatemhamdy miniopenspinousprocesssplittinglaminectomyinthemanagementofcervicalspondyloticmyelopathy AT tarekabotakia miniopenspinousprocesssplittinglaminectomyinthemanagementofcervicalspondyloticmyelopathy AT ahmadallam miniopenspinousprocesssplittinglaminectomyinthemanagementofcervicalspondyloticmyelopathy
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Mini Open Spinous Process Splitting Laminectomy in the management of Cervical Spondylotic Myelopathy

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